Treat the body not the person.
It’s 0441 and I’m now awake, lying in bed listening to the tick of my bedroom clock, the clicking of the radiator after the heating has decided to come on at some random time (must check the settings), and hearing the wind pounding against the window wanting to get in.
So my dream started with me pressing the jackpot combination on a slot machine and the money spitting out onto the floor. I’m trying to gather it in to keep it away from people who are trying to grab it. Then I’m walking past other coin dodger machines and I see money in the trays in almost every one of them?? Then I’m suddenly in the Chinook being punched in the face by an Afghan man.
This was a true event which happened to me on my first tour on MERT. We were called to collect 2 male afghans, possible insurgents who had been injured by a missile after being spotted planting an IED. They had suffered shrapnel wounds. One was more severely wounded than the other. Due to them being possible insurgents the ground call sign are supposed to search them prior to being loaded onto the helicopter. However it soon became clear that they hadn’t been. The most serious casualty was placed in front of the doctor and I looked after the second one. We were still on the ground at this point and I noticed a third afghan chap sat on one of the seats next to my patient. He leant forward trying to get to the patients pockets. I attempted to move him away and he punched me on my jaw; he gave it such a crack! I shouted at our force protection (FP) guys to get him off the chinook and he was quickly escorted off! We then started to take off and I started to search my patient who had a mobile phone, a small pocket mirror, some nails and 2 square batteries. It is well known that mirrors are used by insurgents to send messages by reflection to others on the ground. I can only assume this was the case here because to be fair he didn’t look the type to wear makeup!! All this would be used as evidence later on.
Now throughout our tour all clinicians are armed with an SA80 rifle and a Browning pistol both loaded. Pistols used to be strapped to our chests on the body armour and our rifles on a sling on our backs when treating patients. However, with insurgents wanting to ‘take out a bird’ (our chinook) it was not safe. As we work on our knees leaning over the casualty it would only take a second for them to snatch our pistol from its holster. For precaution the first thing we would do is place blacked out goggles on those suspected of being insurgents so they did not see our faces. I would have my pistol strapped to my thigh out of reach and my rifle was always handed to the FP guys for safety.
Despite our personal feelings towards insurgents clinicians had to remain neutral. Also the Taliban weren’t fighting a conventional war so they had no consideration for the Rules of Engagement nor the Geneva Convention. In fact although we should have, paramedics would not step foot on the ground with a red cross armband on because you were considered a target. One afghan male was airlifted to hospital following injury and whilst being x rayed the radiologist identified a Grenade embedded in his leg!! A very brave surgeon and a few other members of staff took a corner of the hospital which had been evacuated, and with body armour on carried out surgery to remove the Grenade which bomb disposal then dealt with.
Even knowing all this you still have to afford them the same treatment regardless of personal feeling. I have to admit that it stuck in my throat every time I treated a known insurgent. I felt sick to the stomach and I probably looked at them with hate in my eyes, just as they did with me, especially the one who punched me square in the jaw! I still however gave them eye protection (albeit) blacked out, and ear defenders to protect their ears from the noise. I also still wrapped them up to protect them from the elements once their wounds had been sorted. These are the moments I switch off and look at the body instead of the person.
From this shout the more severe casualty passed away from injuries sustained. Once we landed at Camp Bastion the Afghans were loaded into the waiting ambulances. The routine is that the most severe casualty gets loaded into an ambulance first and off they go with sirens on to alert the hospital to their arrival. The deceased are left until last and are driven direct to the morgue. I always hated this bit because I had to sometimes escort the bodies. So we pulled up to the morgue with the insurgent and the ambulance doors were pulled open by waiting staff. Screens had been placed around to ensure noone in ED would have to see. However where the entrance to the morgue was there was an open area and the first thing I saw was 4 local national workers stood watching me. This made me feel really uncomfortable. As the body was unloaded from the ambulance his blood, which already lay in a pool in the ambulance started to trickle through the stretcher and onto the floor. The doors to the morgue where opened, the stretcher was placed on a trolly and wheeled in. These workers continued to stare and I had to walk past them because I then had to go and have my jaw checked. These same workers then had to wash the blood from the stretcher and the floor…
The other casualty would be treated in a cordoned off area of the hospital under guard, stabilised and then accommodated in the detention centre where the military police would try to gather any useful intelligence. They will also look through any evidence we hand over such as the mobile phone. The way I accept having to treat them equally is by knowing that they may provide intel which could lead to arrests of known leaders and ultimately reduced the number of KIA’s and maimed.
Thankfully my jaw was ok but I was so very angry and really wanted to punch him back!! Although the taliban had no regard for rules of armed conflict clinicians as I have already stated must remain neutral. It’s much like those in the NHS who work in prisons with murderers and pedophiles, it doesn’t matter what our beliefs and values are you have to treat everyone equally. You could be full of hatred inside and perhaps sometimes it makes you feel physically sick with disgust yet you cannot outwardly display these feelings. Treat the body not the person is how I got through it.
Going back to my dream, after the Afghan man punched me I pushed him off the helicopter whilst it was in the air. When I turned back to my patient he had his phone in his hand, pressed a button and he exploded with body parts and contents splashing across the cab. Noone else was injured which was really freaky.
Then weirdly my dream ended with me in a kitchen eating a fried egg butty (don’t even like fried egg) then trying to clean the worktop which had a pile of sugar spilt on it?? Lozzie comes downstairs and I ask her why she hasn’t had my tea ready because she always has it ready…..
I wake up and my beds wet through with sweat. I thought I’d wet myself again but thankfully not this time.